Signo del fluido facetario e inestabilidad vertebral segmentaria

• Pedro Luis Bazán ^[1] ; Marco Antonio Rosas Mendieta ^[2] ; Emmanuel Padini ^[3] ; Jorge Fernando Carrizo Becerra ^[4] ; Álvaro Enrique Borri ^[1] ; Martín Medina ^[1]
  1. [1] Unidad de Patología Espinal, Servicio de Ortopedia y Traumatología, Hospital Interzonal General de Agudos “General San Martín”, La Plata, Buenos Aires, Argentina
  2. [2] Servicio de Ortopedia y Traumatología, Caja de Salud de Caminos, Hospital Obrero 4, Oruro, Bolivia
  3. [3] Servicio de Ortopedia y Traumatología, Sanatorio Loma Linda, Sáenz Peña, Chaco, Argentina
  4. [4] Servicio de Ortopedia y Traumatología, Clínica Mercedario, Hospital Descentralizado, San Juan, Argentina

  Mostrar afiliaciones +
• Localización: Revista de la Asociación Argentina de Ortopedia y Traumatología, ISSN 1852-7434, Vol. 88, Nº. 3, 2023, págs. 269-274
• Idioma: español
• DOI: 10.15417/issn.1852-7434.2023.88.3.1511
• Títulos paralelos:
  • Facet Fluid sign and segmental Instability of the spine
• Enlaces
  • Texto completo  1    2  
• Resumen
  • español

    Introducción: La enfermedad degenerativa de la columna lumbar es frecuente, pero aún existen dudas en relación con los criterios de inestabilidad.

    Objetivos: Analizar la relación del signo del fluido facetario lumbar como criterio de inestabilidad vertebral segmentaria.

    Materiales y Métodos: Pacientes con enfermedad lumbar crónica, que presentan hidrartrosis facetaria en la resonancia magnética y las radiografías de columna lumbar dinámicas. Se analizan la prevalencia del sexo, la edad, la sintomatología principal y el dolor a la extensión unilateral o bilateral.

    Resultados: Se evaluó a 139 pacientes (62% mujeres), con un promedio de edad de 50.8 años; el principal motivo de consulta fue lumbalgia (76%). El 65% refería dolor en extensión; el 35%, dolor unilateral y el 30%, dolor bilateral. El 14% tenía espondilolistesis de bajo grado en L4-L5 y el 7%, en L5-S1. La hidrartrosis era unilateral en el 20% y bilateral en el 80%; el nivel de hidrartrosis más frecuente era en L4-L5 (58%). El 6% tenía solo inestabilidad traslacional y el 2%, mixta. Un 8% presentaba Modic I y un 5%, Modic II.

    Conclusiones: La presencia de fluido facetario no es un criterio de inestabilidad vertebral segmentaria, al margen del nivel y el segmento localizado, o la presentación facetaria lumbar unilateral o bilateral.

  • English

    Introduction: Degenerative lumbar spine disease is prevalent, however, the criteria for instability are still debated. Objectives:To analyze the presence of the lumbar facet fluid sign as a criterion for segmental instability of the spine. materials and meth-ods: Patients with chronic lumbar disease, who present facet hydrarthrosis on MRI and dynamic lumbar spine radiographs. The prevalence of sex, age, main symptomatology, and pain on unilateral or bilateral extension was investigated. Results: A total of 139 patients (62% women) were evaluated, with an average age of 50.8 years; the main reason for consultation was low back pain (76%). Sixty-five percent reported pain in extension, with 35% reporting unilateral pain and 30% reporting bilateral pain. Fourteen percent had low-grade spondylolisthesis at L4-L5 and 7% at L5-S1. Hydrarthrosis was unilateral in 20% and bilateral in 80%; the most frequent level of hydrarthrosis was L4-L5 (58%). Six percent had only translational instability and 2% had mixed instability. 8% and 5%, respectively, had Modic I and Modic II changes. Conclusions: The presence of facet fluid is not a criterion for segmental instability of the spine, regardless of the level and localized segment, or the unilateral or bilateral lumbar facet presentation.

• Referencias bibliográficas
  • Wang D, Yuana H. Analysis of the relationship between the facet fluid sign and lumbar spine motion of degenerative spondylolytic segment using...
  • Sethi R. Relationship betwen disc degeneration and facet joint arthrosis a MRI study. J Anat Soc India 2016;65:123-7. https://doi.org/10.1016/j.jasi.2017.02.010
  • Fujiwara A, Tamai K, An HS, Lim TH, Yoshida H, Kurihashi A, et al. Orientation and osteoarthritis of the lumbar facet joint. Clin Orthop Relat...
  • Chaput C, Padon D, Rush J, Lenehan E, Rahm M. The significance of increased fluid signal on magnetic resonance imaging in lumbar facets in...
  • Hasegawa K, Kitahara K, Shimoda H, Ishii K, Ono M, Homma T, et al. Lumbar degenerative spondylolisthesis is not always unstable: clinicobiomechanical...
  • Hasegawa K, Shimoda H, Kitahara K, Sasaki K, Homma T. What are the reliable radiological indicators of lumbar segmental instability? J Bone...
  • Rihn JA, Lee JY, Khan M, Ulibarri JA, Tannoury C, Donaldson WF 3rd, et al. Does lumbar facet fluid detected on magnetic resonance imaging...
  • Lattig F, Fekete TF, Grob D, Kleinstück FS, Jeszenszky D, Mannion AF. Lumbar facet joint effusion in MRI: a sign of instability in degenerative...
  • Helbig T, Lee CK. The lumbar facet syndrome. Spine (Phila Pa 1976) 1988;13(1):61-4. https://doi.org/10.1097/00007632-198801000-00015
  • Fujiwara A, Tamai K, Yamato M, An HS, Yoshida H, Saotome K, et al. The relationship between facet joint osteoarthritis and disc degeneration...
  • Phan KH, Daubs MD, Kupperman AI, Scott TP, Wang JC. Kinematic analysis of diseased and adjacent segments in degenerative lumbar spondylolisthesis....
  • Dupuis PR, Yong-Hing K, Cassidy JD, Kirkaldy-Willis WH. Radiologic diagnosis of degenerative lumbar spinal instability. Spine (Phila Pa 1976)...
  • Boden SD, Wiesel SW. Lumbosacral segmental motion in normal individuals. Have we been measuring instability properly? Spine (Phila Pa 1976)...
  • Bazán PL, Borri AE, Medina M. Correlación entre signo de Modic I e inestabilidad radiográfica dinámica. Coluna/Columna 2021;20(4):259-62....
  • Ciccioli NM, Medina M, Bazán PL, Borri AE. Artritis séptica facetaria en columna. Orthotips 2021;17(1):6-10. https://doi.org/10.35366/99161